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ADHD drugs do not increase risk

There is no evidence that current use of an attention deficit-hyperactivity disorder (ADHD) drug increases the risk of serious cardiovascular events in children and young adults, according to a retrospective cohort study1 published recently in the New England Journal of Medicine.

Researchers examined data from four health plans (Tennessee Medicaid, Washington State Medicaid, Kaiser Permanente California, and OptumInsight Epidemiology), with 1,200,438 children and young adults between the ages of 2 and 24 years and 2,579,104 person-years of follow-up, including 373,667 person-years of current use of ADHD drugs.

They identified serious cardiovascular events (sudden cardiac death, acute myocardial infarction, and stroke) from health-plan data and vital records, with end points validated by medical-record review. They estimated the relative risk of end points among current users, as compared with nonusers, with hazard ratios from Cox regression models.

Cohort members had 81 serious cardiovascular events (3.1 per 100,000 person-years). Current users of ADHD drugs were not at increased risk for serious cardiovascular events – risk was not increased for any of the individual end points, or for current users as compared with former users. Alternative analyses addressing several study assumptions also showed no significant association between the use of an ADHD drug and the risk of a study end point.

Authors say that, although their study showed no evidence of increased risk of serious events associated with current use of an ADHD drug, the upper limit of the 95% confidence interval indicated that a doubling of the risk could not be ruled out. However, the absolute magnitude of such an increased risk would be low, they add.